Alliance Statement on House Small Business Committee Hearing on Prior Authorization

By proton-admin | September 12, 2019

Today, the U.S. House Small Business Committee examined prior authorization obstacles to doctor-recommended care in a hearing titled “Utilization Management: Barriers to Care and Burdens on Small Medical Practice.

Below is a statement from Daniel E. Smith, Executive Director of the Alliance for Proton Therapy Access:

We applaud Chairwoman Nydia M. Velázquez and the U.S. House Small Business Committee for bringing needed attention to the obstacles insurers use to deny patients access to doctor-recommended treatment. We often hear gut-wrenching stories from cancer patients who find themselves in a battle with an insurance company that’s second guessing the patient’s medical team. As this hearing and the expert testimony made clear, the insurance review process is broken.

Prior authorization is too often used to delay or improperly deny treatment. Far too many cancer patients find themselves waiting days, weeks, or even months for an opaque process to play out. Meanwhile, their cancer and anxiety grow. Many times patients face a series of bad choices. They may continue waiting for treatment, while their cancer worsens. They sometimes start treatment without their insurer’s approval, meaning they have no guarantee of payment. Or they opt for a cancer treatment that is less effective or poses higher health risks. Cancer patients deserve better than this.

It’s time for Congress to hold insurers accountable for providing a fair and prompt review process to cancer patients facing a life-threatening illness. The principles outlined in our Cancer Patients’ Timely Treatment Bill of Rights provide a framework that Congress can adopt to balance the scales between patients and insurers.